Ren Jing-Qing, Zhang Han-Shuo, Zhang Li-Hua, Zhong Qi-Guang, Wu Fan, Wang Bai-Lin, Liu Shao-Jie
Department of General Surgery, Medical College, Jinan University, Guangzhou Red Cross Hospital, Guangzhou, China.
J Gastrointest Oncol. 2021 Aug;12(4):1558-1567. doi: 10.21037/jgo-21-317.
Adjuvant chemotherapy for 6 months following surgery is the standard treatment plan for stage III colon cancer. The aim of the present study was to determine whether the adjuvant chemotherapy completion time for stage III colon cancer had an effect on prognosis and cut-off time that affected the prognosis.
This was a retrospective study of stage III colon cancer patients who completed adjuvant chemotherapy at Guangzhou Red Cross Hospital from January 2010 to December 2017. Univariate and multivariate analyses were used to determine the association between adjuvant chemotherapy completion time and the 3-year disease-free survival (DFS). The restricted cubic spline model was used to analyze the cut-off time that affected the 3-year DFS.
A total of 431 patients were included in the study. The 3-year DFS was associated with a combination of obstruction or perforation, preoperative serum carcino-embryonic antigen (CEA) concentration, T stage, N stage, pathological stage, and adjuvant chemotherapy completion time in the univariate analysis (P<0.05). A combination of obstruction or perforation, preoperative serum CEA concentration, N stage, and adjuvant chemotherapy completion time were independent prognostic factors in the multivariate analysis (P<0.05). The cut-off time was 28 weeks for adjuvant chemotherapy completion time in the restricted cubic spline model analysis. For those whose adjuvant chemotherapy completion time was >28 weeks, the risk of 3-year recurrence was 1.428 times higher compared with those whose adjuvant chemotherapy completion time was ≤28 weeks. [P=0.032, 95% confidence interval (CI): 1.034-2.055].
The 3-year DFS of stage III colon cancer was related to the adjuvant chemotherapy completion time. For those who completed adjuvant chemotherapy >28 weeks, the risk of 3-year recurrence increased.
术后进行6个月的辅助化疗是III期结肠癌的标准治疗方案。本研究的目的是确定III期结肠癌辅助化疗的完成时间是否对预后有影响以及影响预后的截止时间。
这是一项对2010年1月至2017年12月在广州红十字会医院完成辅助化疗的III期结肠癌患者的回顾性研究。采用单因素和多因素分析来确定辅助化疗完成时间与3年无病生存率（DFS）之间的关联。使用受限立方样条模型分析影响3年DFS的截止时间。
本研究共纳入431例患者。单因素分析显示，3年DFS与梗阻或穿孔、术前血清癌胚抗原（CEA）浓度、T分期、N分期、病理分期及辅助化疗完成时间有关（P<0.05）。多因素分析显示，梗阻或穿孔、术前血清CEA浓度、N分期及辅助化疗完成时间是独立的预后因素（P<0.05）。受限立方样条模型分析中辅助化疗完成时间的截止时间为28周。辅助化疗完成时间>28周的患者，其3年复发风险是辅助化疗完成时间≤28周患者的1.428倍。[P=0.032，95%置信区间（CI）：1.034 - 2.055]。
III期结肠癌的3年DFS与辅助化疗完成时间有关。辅助化疗完成时间>28周的患者，其3年复发风险增加。
